Scribd
Upload
84 views1 page

SF-23 Risk Assessment

Uploaded by

Adam Banoura
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
84 views1 page

SF-23 Risk Assessment

Uploaded by

Adam Banoura
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 1

HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM SBSM

Ship Name: Consequence Refer to Chapter 10 of Health, Safety and Pollution Prevention Manual, for guidance to fill out this form. This form is filled for
every foreseeable jobs, routine and non-routine jobs on board and compiled as Sample risk assessment in the data base -
MODERATE Level 1 risk assessment.
able HARM
TSLIGHT HARM
SERIOUS HARM EXTREME HARM
Date: Risk In addition to Level 1 risk assessment, this form may be used to prepare Leve 2 risk assessments as given in S&H Ch 10 Sec
10.4.2 and Technical Manual Ch 3 Sec 3.2.3 - Examples as below however for complete list refer to S&H Ch 10 Sec 10.4.2:
VERY
UNLIKELY
Very Low Very Low Low Medium 1. If the task is new or unfamiliar (OR) it is not possible to comply fully with local procedures.
Nature of work:

Likelihood
2. Permits as mentioned in S&H Ch 10 Sec 10.4.2 and lowering life boats for manoeuvering in water
UNLIKELY Very Low Low Medium High 3. When master reassess an existing work activity / New or Unknwon port of call/ Loading or unloading new type of cargo.
Area of Work
4. Company requests Master to carry out detailed assessment for a particular work activity. (6) Navigating with defective
LIKELY Low Medium High Very High bridge equipment
Work Activity being assessed:
5. When a critical equipment is shutdown for maintenance (Refer Technical Manual Chapter 3 Sec 3.2.3)
VERY LIKELY High High Very High Very High 6.Hazards control if fails, relevant contingency plan to be used where applicable.

Existing Risk Modified Risk Reme


dial
Hazard Review
Hazard Existing Control Measure Conse Further Risk Control Measures Conse Pic Sign Actio
No. Likelih Likeli Date
quence Risk quenc Risk n
ood hood Date
s es

Risk Assesment done by Approved By

Task Commencement Time Task Completed Time

HAZARD IDENTIFICATION AND RISK ASSESSMENT WERE DISCUSSED / BRIEFED TO THE FLWG CREW MEMBERS ( Applicable to level 2 RA only)

Name Rank Signature Name Rank Signature Name Rank Signature

Rev.No.:0
Original: Vessel Date: 1-Jan-23
Copy: Office SF-23
Page 1 of 1

You might also like